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Palomo Atance E, Caballero Mora FJ, Espadas Maciá D, Marbán Calzón M, Sevilla Ramos P, García Villaescusa L, Dabad Moreno MJ, Muñoz-Rodríguez JR, Ruiz Cano R. Triponderal mass index and markers of metabolic risk in children and adolescents with obesity. Med Clin (Barc) 2023; 160:379-384. [PMID: 36631326 DOI: 10.1016/j.medcli.2022.09.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/19/2022] [Accepted: 09/22/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND OBJECTIVE Triponderal mass index (TMI) would estimate excess adiposity better than body mass index (BMI), maintaining stable values during childhood. This work aims to determine the correlation between TMI and markers of metabolic risk as well as set values of TMI that are related to an increase of metabolic risk. MATERIAL AND METHODS Multicenter, observational, cross-sectional and prospective study in children under 14 years of age with obesity. VARIABLES age, sex, pubertal stage, weight, height, abdominal circumference, BMI, TMI, basal glucose and insulin, HOMA index, blood pressure, lipoprotein profile, transaminases and uric acid. BMI and TMI were expressed according to the values of the Barcelona longitudinal study. Statistical analysis was performed with the SPSS* program. RESULTS One hundred and ninety-nine patients (50.3% male), age 11.08 (2.48) years, TMI 19.68 (2.36)kg/m3. Correlation between TMI and abdominal circumference (r=0.571; p=0), insulin (r=0.198; p=0.005), HOMA index (r=0.189; p=0.008) and HDL-c (r=-0.188; p=0.008) was observed. IMT>20.15kg/m3 was associated with insulin≥15mIU/ml (p=0.029) and IMT>20.36kg/m3 with HDL-c<40mg/dl (p=0.023). CONCLUSIONS TMI was correlated with increase of abdominal circumference, insulin and HOMA index and decrease of HDL-c. IMT>20kg/m3 can be associated with increased insulin and decreased HDL-c. Therefore, the IMT seems to be a useful parameter in the assessment of pediatric patients with obesity.
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Affiliation(s)
- Enrique Palomo Atance
- Endocrinología Pediátrica, Servicio de Pediatría, Hospital General Universitario de Ciudad Real, Grupo de Endocrinología Pediátrica de Castilla-La Mancha (GEPCAM), Ciudad Real, España.
| | - Francisco Javier Caballero Mora
- Endocrinología Pediátrica, Servicio de Pediatría, Hospital Santa Bárbara, Grupo de Endocrinología Pediátrica de Castilla-La Mancha (GEPCAM), Puertollano, Ciudad Real, España
| | - David Espadas Maciá
- Endocrinología Pediátrica, Servicio de Pediatría, Hospital Virgen de la Luz, Grupo de Endocrinología Pediátrica de Castilla-La Mancha (GEPCAM), Cuenca, España
| | - Mercedes Marbán Calzón
- Endocrinología Pediátrica, Servicio de Pediatría, Hospital General La Mancha Centro, Grupo de Endocrinología Pediátrica de Castilla-La Mancha (GEPCAM), Alcázar de San Juan, Ciudad Real, España
| | - Pilar Sevilla Ramos
- Endocrinología Pediátrica, Servicio de Pediatría, Hospital Universitario de Guadalajara, Grupo de Endocrinología Pediátrica de Castilla-La Mancha (GEPCAM), Guadalajara, España
| | - Lourdes García Villaescusa
- Endocrinología Pediátrica, Servicio de Pediatría, Hospital General de Almansa, Grupo de Endocrinología Pediátrica de Castilla-La Mancha (GEPCAM), Almansa, Albacete, España
| | - María Jesús Dabad Moreno
- Endocrinología Pediátrica, Servicio de Pediatría, Hospital General Universitario de Albacete, Grupo de Endocrinología Pediátrica de Castilla-La Mancha (GEPCAM), Albacete, España
| | - José Ramón Muñoz-Rodríguez
- Unidad de Investigación Traslacional, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| | - Rafael Ruiz Cano
- Endocrinología Pediátrica, Servicio de Pediatría, Hospital General Universitario de Albacete, Grupo de Endocrinología Pediátrica de Castilla-La Mancha (GEPCAM), Albacete, España
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Early predictors of short duration of exclusive breastfeeding among Havana women. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Yeste D, Clemente M, Campos A, Fábregas A, Mogas E, Soler L, Carrascosa A. Diagnostic accuracy of the tri-ponderal mass index in identifying the unhealthy metabolic obese phenotype in obese patients. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2021. [DOI: 10.1016/j.anpede.2020.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Jang CY, Gim NG, Kim Y, Kim T. Multi-Year Examination of School-Based Programs in Preventing Childhood Obesity: A Case of a State Policy in the U.S. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9425. [PMID: 33339166 PMCID: PMC7765664 DOI: 10.3390/ijerph17249425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/12/2020] [Accepted: 12/14/2020] [Indexed: 01/21/2023]
Abstract
This study examined the association between the obesogenic factors and the risk of suffering from weight excess in school-based state programs regarding physical activity, physical education, nutrition standards, and nutrition education in preventing childhood obesity. Data were drawn from the 1999-2011 Youth Risk Behavior Survey in the State of Mississippi (N = 8862; grades 9-12). Logistic regression with year-fixed effects was performed to capture the influence of the legislation on teenage obesity, controlling for demographics and nutrition- and physical activity-related behaviors. The age-, sex-, and ethnicity-adjusted mean of the body mass index had reduced since 2007 (year 1999: 23.52; year 2001: 23.53; year 2003: 23.76; year 2007: 24.26; year 2009: 24.29; and year 2011: 23.91). The legislation was significantly associated with a decreased likelihood of being overweight (year 2007, odds ratio (OR) = 0.686; year 2009, OR = 0.739; and year 2011, OR = 0.760; all p < 0.01). Children who were more sedentary, more frequently fasted to lose weight, and were less physically active and likelier to be overweight (OR = 1.05, 1.37, and 0.97, respectively; all p < 0.05), as were African-American children (OR = 0.64; p < 0.05) and female students (OR = 1.59; p < 0.05). In conclusion, schools are among the most easily modifiable settings for preventing childhood obesity and reducing its prevalence, with the implementation of physical activity and nutritional policies.
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Affiliation(s)
| | - Nam-Gyeong Gim
- Department of Administration, Yuk-buk Elementary School, Yongin 17061, Korea;
| | - Yoonhee Kim
- Graduate School of Education, Soonchunhyang University, Asan 31538, Korea;
| | - TaeEung Kim
- Department of Epidemiology, University of California, Irvine, CA 92697, USA
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Yeste D, Clemente M, Campos A, Fábregas A, Mogas E, Soler L, Carrascosa A. [Diagnostic accuracy of the tri-ponderal mass index in identifying the unhealthy metabolic obese phenotype in obese patients]. An Pediatr (Barc) 2020; 94:68-74. [PMID: 32446672 DOI: 10.1016/j.anpedi.2020.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 03/25/2020] [Accepted: 04/02/2020] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The metabolically healthy obese (MHO) phenotype defines obese patients who have preserved insulin sensitivity and absence of metabolic complications. This phenotype is associated with a lower risk of cardiovascular disease and type2 diabetes in adulthood. OBJECTIVES To determine the prevalence of MHO and the metabolically unhealthy obesity (MUO) phenotype in a cohort of obese children and adolescents and to establish the predictive capacity of the tri-ponderal mass index (TMI) and other anthropometric parameters in order to identify these patients. PATIENTS AND METHODS A cross-sectional study was conducted on 239 obese patients (125males) from 8 to 18years of age. Grade3 obesity was present in 45.9% of the patients. ROC curves were used to find the best cut-off point for: TMI, body mass index (BMI), BMI z-score (BMIzs), and waist/height index (WHI). MHO components: plasma blood glucose, plasma triglycerides, HDL-cholesterol, and blood pressure. RESULTS The prevalence of MUO in the study cohort was 62.4%. No differences between genders were observed, and it was increasing with the age and obesity degree. The TMI has a sensitivity of 75.8 and a specificity of 42.2 to identify the MUO patients. The best cut-off point for TMI is 18.7kg/m3, for BMI it was 30.4kg/m2, for BMIzs +3.5SD, and 0.62 for WHI. CONCLUSIONS The diagnostic accuracy of TMI in identifying obese adolescents with metabolic risk was similar to BMI and WHI. However, the TMI is much simpler to use and simplifies the categorization of the obesity in both genders.
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Affiliation(s)
- Diego Yeste
- Sección de Endocrinología Pediátrica, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona. CIBER de Enfermedades Raras (CIBERER) ISCIII, Barcelona, España.
| | - María Clemente
- Sección de Endocrinología Pediátrica, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona. CIBER de Enfermedades Raras (CIBERER) ISCIII, Barcelona, España
| | - Ariadna Campos
- Sección de Endocrinología Pediátrica, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona. CIBER de Enfermedades Raras (CIBERER) ISCIII, Barcelona, España
| | - Anna Fábregas
- Sección de Endocrinología Pediátrica, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona. CIBER de Enfermedades Raras (CIBERER) ISCIII, Barcelona, España
| | - Eduard Mogas
- Sección de Endocrinología Pediátrica, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona. CIBER de Enfermedades Raras (CIBERER) ISCIII, Barcelona, España
| | - Laura Soler
- Sección de Endocrinología Pediátrica, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona. CIBER de Enfermedades Raras (CIBERER) ISCIII, Barcelona, España
| | - Antonio Carrascosa
- Sección de Endocrinología Pediátrica, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona. CIBER de Enfermedades Raras (CIBERER) ISCIII, Barcelona, España
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Vasquez F, Corvalan C, Uauy R, Kain J. Impact of gaining or maintaining excessive weight in infancy on markers of metabolic homeostasis in young children: A longitudinal study in Chilean children. Prev Med Rep 2018; 12:298-303. [PMID: 30406008 PMCID: PMC6214876 DOI: 10.1016/j.pmedr.2018.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 10/04/2018] [Accepted: 10/14/2018] [Indexed: 11/16/2022] Open
Abstract
Childhood obesity in Chile is one of the highest in the world. The objective of this study was to assess the impact of excessive weight gained or maintained over a 3-year period, on markers of metabolic homeostasis in young children. This is a longitudinal study which includes 243 children followed from 4 to 7 years. We assessed BMI, body fat percentage, waist circumference (WC), waist-hip ratio (WHR), waist-height (WH) and trunk fat as well as the following metabolic parameters: glucose, insulin, triglycerides, total cholesterol, LDL, HDL and metabolic risk score. Kruskal- Wallis was used to assess differences in metabolic markers by nutritional status and logistic regression to determine the effect of maintaining or gaining excess weight over the 3-year period, compared with children who maintained a normal weight. Children who were obese at both ages compared with those who were normal weight, had a significantly higher WC, serum concentrations of total fat, total cholesterol, triglycerides, LDL cholesterol and metabolic risk score (P < 0.05). Children who were overweight or obese at 4 and 7 years, had a greater risk of having a high WC (OR: 3.37; P = 0.03), total cholesterol (OR: 4.17; P < 0.003), triglycerides (OR: 1.96; P = 0.04); thus a higher metabolic risk score (OR: 3.21; P = 0.003). Excess weight maintained over time in early childhood, significantly increases the risk of having higher serum biomarkers of cardiovascular risk, which in turn determines the magnitude of cardiovascular and metabolic risks later in life. A Chilean cohort study followed from 4 to 7 years showed that the prevalence of overweight/obese increased from 32 to 35%. 23% of children remained overweight/obese at both ages. 13% of children changed from normal to overweight. Excess weight maintained over time increases disruption of metabolic homeostasis. Cardiovascular parameters may determine the magnitude of cardiovascular risks.
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Affiliation(s)
- Fabian Vasquez
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Camila Corvalan
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Ricardo Uauy
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Juliana Kain
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
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Abstract
PURPOSE In recent years, the incidence of childhood obesity in Europe, and Spain in particular, has increased dramatically. Bariatric surgery could play a major role in treating of adolescents with severe obesity. However, no specific guidelines for bariatric surgery currently exist in Spain. METHODS The Board of the Spanish Society for Obesity Surgery and Metabolic Diseases (SECO) proposed a study of childhood obesity by using the Delphi method. This prospective study involved 60 experts from nine national societies. Each society leader recruited experts from their society in obesity-related fields. Two online questionnaires were taken, and consensus on guidelines for various obesity treatments was reached according to the percentage of answers in favor or against inclusion of a given guideline. Based on these results, preoperative, surgical management and follow-up of childhood obesity management among others were analyzed. RESULTS The survey results indicated significant concern among all societies regarding obesity. There was strong consensus with regard to adolescents and obesity, medical treatment, dietary recommendations, environmental and social factors, and goals for adolescents with obesity. Consensus on the use of intragastric balloons and other techniques was not reached. However, biliopancreatic diversion was rejected as a primary treatment, and mandatory psychological/psychiatric assessment was agreed upon. Inclusion criteria accepted were similar to those for adults with the exception of surgery in those with a body mass index <40. CONCLUSIONS Spanish obesity-related societies are aware of the societal problem of childhood obesity. Multisociety development of national approaches may arise from consensus-building studies among specialists.
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Costa PRDF, Assis AMO, Cunha CDM, Pereira EM, de Jesus GDS, da Silva LEM, Alves WPDO. Hypertriglyceridemic Waist Phenotype and Changes in the Fasting Glycemia and Blood Pressure in Children and Adolescents Over One-Year Follow-Up Period. Arq Bras Cardiol 2017; 109:47-53. [PMID: 28562834 PMCID: PMC5524475 DOI: 10.5935/abc.20170067] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 02/01/2017] [Accepted: 02/08/2017] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND: The hypertriglyceridemic waist (HTW) phenotype is defined as the simultaneous presence of increased waist circumference (WC) and serum triglycerides (TG) levels and it has been associated with cardiometabolic risk in children and adolescents. OBJECTIVE: The objective was to evaluate the influence of HTW phenotype in the fasting glycemia and blood pressure in children and adolescents over one-year follow-up period. METHODS: It is a cohort study involving 492 children and adolescents from 7 to 15 years old, both genders, who were submitted to anthropometric, biochemical and clinical evaluation at the baseline, and also after 6 and 12 months of follow-up. Generalized Estimating Equation (GEE) models were calculated to evaluate the longitudinal influence of the HTW phenotype in the glycemia and blood pressure over one-year. RESULTS: It was observed a prevalence of 10.6% (n = 52) of HTW phenotype in the students. The GEE models identified that students with HTW phenotype had an increase of 3.87 mg/dl in the fasting glycemia mean (CI: 1.68-6.05) and of 3.67mmHg in the systolic blood pressure (SBP) mean (CI: 1.55-6.08) over one-year follow-up, after adjusting for confounding variables. CONCLUSIONS: The results of this study suggest that HTW phenotype is a risk factor for longitudinal changes in glycemia and SBP in children and adolescents over one-year follow-up period. FUNDAMENTO: O fenótipo de cintura hipertrigliceridêmica (CHT) é definido como a presença simultânea de circunferência de cintura (CC) e níveis séricos de triglicérides (TG) aumentados e tem sido associado com risco cardiometabólico em crianças e adolescentes. OBJETIVO: Avaliar a influência do fenótipo CHT na glicemia de jejum e na pressão arterial em crianças e adolescentes em um período de acompanhamento de um ano. MÉTODOS: Trata-se de um estudo de coorte envolvendo 492 crianças e adolescentes de 7 a 15 anos de ambos os sexos, que foram submetidos à avaliação antropométrica, bioquímica e clínica no início e também após 6 e 12 meses de seguimento. Os modelos de Equação de Estimulação Generalizada (GEE) foram calculados para avaliar a influência longitudinal do fenótipo CHT na glicemia e na pressão arterial ao longo de um ano. RESULTADOS: Foi observada uma prevalência de 10,6% (n = 52) do fenótipo CHT nos estudantes. Os modelos GEE identificaram que os estudantes com fenótipo CHT apresentaram aumento de 3,87 mg/dl na média de glicemia em jejum (IC: 1,68-6,05) e de 3,67 mmHg na pressão arterial sistólica media (PAS) (IC: 1,55-6,08) depois de um ano de acompanhamento, após ajuste para variáveis de confusão. CONCLUSÕES: Os resultados deste estudo sugerem que o fenótipo CHT é um fator de risco para alterações longitudinais da glicemia e da PAS em crianças e adolescentes em um período de um ano de seguimento.
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Abstract
BACKGROUND Metabolic syndrome (MetS) is considered an independent risk factor for developing cardiovascular disease. It is well known that the prevalence of metabolic disorders have increased in pediatric HIV-infected children. The objective of this study is to assess the prevalence and characteristics of MetS in HIV-infected children and adolescents in Spain. METHODS A cross-sectional multicenter study in 152 patients from the pediatric cohort of the Spanish AIDS Research Network (CoRISpe) was performed. MetS was defined according to the new International Diabetes Federation (IDF) diagnostic criteria and the modified National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria. Measurements included anthropometry, waist circumference, blood pressure, fasting lipids, glucose and insulin and lipodystrophy assessment. Demographic, clinical, immunological, virological and antiretroviral therapy data were obtained from the Network database. RESULTS An abnormally low high-density lipoprotein-cholesterol level was the most prevalent disturbance (21.05%) found. Three patients met IDF criteria for MetS (1.97%), and MetS was significantly associated with lipohypertrophy (P=0.029) in the analysis. When the modified NCEP-ATP III criteria were used, the prevalence of MetS was 5.92% (9 patients), and MetS was significantly associated with Tanner stage ≥2 (P=0.041), lipohypertrophy (P=0.001) and higher Z scores for weight and body mass index (P=0.002 and P<0.001). Insulin resistance was observed in 17 patients (11.18%) and was associated with MetS (as per the modified NCEP-ATP III criteria) (P=0.03) and lower high-density lipoprotein-cholesterol values (P=0.036). CONCLUSIONS The prevalence of MetS in our cohort was 1.97% or 5.92%, depending on the diagnostic criteria used. MetS should be actively assessed, particularly in children who show lipohypertrophy.
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González-Zavala M, Velasco-Morales A, Terrazas-Flores J, de la Cruz-Galicia M, Cepeda-Nieto A, Hernández-del Río A. Levels of insulin and HOMA-IR in adolescents in Saltillo, Coahuila, Mexico. MEDICINA UNIVERSITARIA 2015. [DOI: 10.1016/j.rmu.2015.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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Velásquez-Rodríguez CM, Velásquez-Villa M, Gómez-Ocampo L, Bermúdez-Cardona J. Abdominal obesity and low physical activity are associated with insulin resistance in overweight adolescents: a cross-sectional study. BMC Pediatr 2014; 14:258. [PMID: 25301371 PMCID: PMC4286933 DOI: 10.1186/1471-2431-14-258] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 09/23/2014] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Previous studies have assessed the metabolic changes and lifestyles associated with overweight adolescents. However, these associations are unclear amongst overweight adolescents who have already developed insulin resistance. This study assessed the associations between insulin resistance and anthropometric, metabolic, inflammatory, food consumption, and physical activity variables amongst overweight adolescents. METHODS This cross-sectional study divided adolescents (n = 120) between 10 and 18 years old into 3 groups: an overweight group with insulin resistance (O + IR), an overweight group without insulin resistance (O-IR), and a normal-weight control group (NW). Adolescents were matched across groups based on age, sex, pubertal maturation, and socioeconomic strata. Anthropometric, biochemical, physical activity, and food consumption variables were assessed. Insulin resistance was assessed using homeostatic model assessment (HOMA Calculator Version 2.2.2 from ©Diabetes Trials Unit, University of Oxford), and overweight status was assessed using body mass index according to World Health Organization (2007) references. A chi-square test was used to compare categorical variables. ANOVAs or Kruskal-Wallis tests were used for continuous variables. Multiple linear regression models were used to calculate the probability of the occurrence of insulin resistance based on the independent variables. RESULTS The risk of insulin resistance amongst overweight adolescents increases significantly when they reach a waist circumference > p95 (OR = 1.9, CIs = 1.3-2.7, p = 0.013) and watch 3 or more hours/day of television (OR = 1.7, CIs = 0.98-2.8, p = 0.033). Overweight status and insulin resistance were associated with higher levels of inflammation (hsCRP ≥1 mg/L) and cardiovascular risk according to arterial indices. With each cm increase in waist circumference, the HOMA index increased by 0.082; with each metabolic equivalent (MET) unit increase in physical activity, the HOMA index decreased by 0.026. CONCLUSIONS Sedentary behaviour and a waist circumference > p90 amongst overweight adolescents were associated with insulin resistance, lipid profile alterations, and higher inflammatory states. A screening that includes body mass index, in waist circumference, and physical activity evaluations of adolescents might enable the early detection of these alterations.
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Affiliation(s)
| | - Marcela Velásquez-Villa
- Research Group in Food and Human Nutrition, Universidad de Antioquia (UdeA), Calle 70 No. 52-21, Medellín, Colombia
| | - Leidy Gómez-Ocampo
- Research Group in Food and Human Nutrition, Universidad de Antioquia (UdeA), Calle 70 No. 52-21, Medellín, Colombia
| | - Juliana Bermúdez-Cardona
- Research Group in Food and Human Nutrition, Universidad de Antioquia (UdeA), Calle 70 No. 52-21, Medellín, Colombia
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Rietmeijer‐Mentink M, Paulis WD, van Middelkoop M, Bindels PJ, van der Wouden JC. Difference between parental perception and actual weight status of children: a systematic review. MATERNAL & CHILD NUTRITION 2013; 9:3-22. [PMID: 23020552 PMCID: PMC6860751 DOI: 10.1111/j.1740-8709.2012.00462.x] [Citation(s) in RCA: 166] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
An increasing number of children worldwide are overweight, and the first step in treating obesity is to identify overweight. However, do parents recognise overweight in their child and which factors influence parental perception? The aim of the present review is to systematically study differences between parental perception and the actual weight status of children. Medline, EMbase, CINAHL and PsychINFO were searched. After screening 2497 abstracts and 106 full texts, two reviewers independently scored the methodological quality of 51 articles (covering 35 103 children), which fulfilled the inclusion criteria. The primary outcome parameters were sensitivity and specificity of parental perception for actual weight status of their child. The methodological quality of the studies ranged from poor to excellent. Pooled results showed that according to objective criteria 11 530 children were overweight; of these, 7191 (62.4%) were incorrectly perceived as having normal weight by their parents. The misperception of overweight children is higher in parents with children aged 2-6 years compared with parents of older children. Sensitivity (correct perception of overweight) of the studies ranged from 0.04 to 0.89, while specificity (correct perception of normal weight) ranged from 0.86 to 1.00. There were no significant differences in sensitivity or specificity for different cut-off points for overweight, or between newer and older studies. Therefore we can conclude that parents are likely to misperceive the weight status of their overweight child, especially in children aged 2-6 years. Because appropriate treatment starts with the correct perception of overweight, health care professionals should be aware of the frequent parental misperception of the overweight status of their children.
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Affiliation(s)
| | - Winifred D. Paulis
- Department of General PracticeErasmus MCUniversity Medical CenterRotterdamThe Netherlands
| | | | - Patrick J.E. Bindels
- Department of General PracticeErasmus MCUniversity Medical CenterRotterdamThe Netherlands
| | - Johannes C. van der Wouden
- Department of General PracticeErasmus MCUniversity Medical CenterRotterdamThe Netherlands
- Department of General Practice and Elderly Care MedicineEMGO Institute for Health and Care ResearchVU University Medical CenterAmsterdamThe Netherlands
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Vilallonga R, Yeste D, Lecube A, Fort JM. Cirugía bariátrica en adolescentes. Cir Esp 2012; 90:619-25. [DOI: 10.1016/j.ciresp.2012.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 09/04/2012] [Accepted: 09/06/2012] [Indexed: 11/29/2022]
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Yeste D, Carrascosa A. El manejo de la obesidad en la infancia y adolescencia: de la dieta a la cirugía. An Pediatr (Barc) 2012; 77:71-4. [DOI: 10.1016/j.anpedi.2012.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Revised: 03/12/2012] [Accepted: 03/14/2012] [Indexed: 11/26/2022] Open
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Enes Romero P, Cano Gutiérrez B, Alvarez Gil N, Martín-Frías M, Alonso Blanco M, Barrio Castellanos R. [Ethnic influence on the prevalence of metabolic syndrome in an obese pediatric population]. An Pediatr (Barc) 2012; 78:75-80. [PMID: 22749673 DOI: 10.1016/j.anpedi.2012.04.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Revised: 03/27/2012] [Accepted: 04/16/2012] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Obesity in children is becoming more prevalent. Obesity and type 2 diabetes is higher in the Latin American immigrant population. OBJECTIVE To analyze the influence of ethnicity on the prevalence of metabolic syndrome (MS) and its components in an obese pediatric population. PATIENTS AND METHODS A retrospective study of 616 obese children and adolescents (BMI ≥2 SD [Hernández 88-04]), was conducted on 142 Latin American children and 474 Caucasians, which compared the prevalence of metabolic syndrome and its components according to modified Cook criteria (2003): obesity+2 or more of the following components: HDL-cholesterol <40mg/dl, triglycerides >110mg/dl, systolic and/or diastolic blood pressure >p90 (Task Force 2004), and impaired glucose metabolism (ADA 2011). Hepatic function, family history of MS, HbA1c, insulin resistance (HOMA) and BMI evolution at one year of treatment with changes in lifestyle (diet and exercise) were also assessed. RESULTS Almost one-third (30.5%) of Latin American children had MS compared to 15.5% of Caucasians (OR=2.4 [CI 95%: 1.5-3.8]), P<.005] and OR=2.5 adjusting for sex, SD-BMI and puberty. Latin American children also had a higher insulin resistance (58.6% vs 42.8%, P<.005) and a worse outcome after one year of treatment. CONCLUSION There is a higher prevalence of MS in our Latin American obese pediatric population with poor adherence to the measures of change in lifestyle, making these patients a group with potentially increased risks of cardiovascular disease in adulthood.
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Affiliation(s)
- P Enes Romero
- Unidad de Diabetes y Endocrinología Pediátrica, Servicio de Pediatría, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain.
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Yeste D, Carrascosa A. [Management of obesity in childhood and adolescence: from diet to surgery]. ACTA ACUST UNITED AC 2012; 59:403-6. [PMID: 22695373 DOI: 10.1016/j.endonu.2012.03.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Accepted: 03/15/2012] [Indexed: 11/27/2022]
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